Being exposed to cigarette smoke as a baby or foetus could reduce a female’s fertility, new Australian research has found.

The three-year study examined the effect that three chemicals found in cigarettes had on ovarian development and egg fertilisation.

It found females who were exposed to the toxins through cigarette smoke during the early stages of life could experience a reduction in the quality and number of their eggs, Professor Eileen McLaughlin from the University of Newcastle said.

“We believe that exposure to these toxins as a foetus dramatically reduces egg quality and quantity before birth and that this reduced fertility may be passed on to the next generation,” Prof McLaughlin said in a statement.

“It means that if your grandmother smoked – either while pregnant with your mother or near her when she was a baby – you and possibly your children may be at risk of reduced fertility.”

According to the Australian Institute of Family Studies, more than one-third of pregnant Australian women under the age of 25 continue to smoke during pregnancy and premature ovarian failure continues to be a major cause of female infertility before the age of 40.

Prof McLaughlin’s research has been published in the Journal of Toxicological Sciences and the Journal of Toxicology and Applied Pharmacology, and was funded by the National Health and Medical Research Council.

Tertia shares 10 things everyone should know about infertility. This post first appeared on the parenting blog Rattle and Mum.

1. Infertility is not your fault!: You are not struggling to have a baby because of something you did wrong in your past. Stop blaming yourself!

2. Infertility is medical condition: It is not part of “God’s plan” that you don’t have a child. It is not that you “weren’t meant to be a mother”. Don’t listen to that stuff. You wouldn’t say “oh, maybe it is part of God’s plan that I am a diabetic, I should just accept it and not seek help”.

3. Infertility is painful: They say that infertility patients are second only to cancer patients in what they will endure to find a cure. That shows you how deep the pain can be. Know that what you are feeling is real. Also know that there is hope!

4. Infertility can break up relationships, if you allow it to: Infertility is can sometimes wreak havoc on relationships. Between you and your husband, between you and your best friend. Be open about what you are feeling. Talk. Communicate. It is so important.

5. Infertility is indiscriminate: Infertility doesn’t care if you are rich or poor, tall or short, black or white. One in 10 couples struggle to conceive. Fact.

6. Infertility is age dependant: I hate to be the bearer of bad tidings but you need to know that your eggs have an expiry date. It doesn’t matter how young you look on the outside, your fertility declines after 35. After 40 your fertility declines rapidly. Don’t leave it too long.

7. Infertility is lonely, but it doesn’t have to be: Being infertile in a fertile world is a lonely place to be, but you don’t need to do this alone. There are so many people who are in the same boat as you and who get how you feel. Join a support group like Fertilicare – you can even join anonymously.

8. Infertility needn’t be a life sentence: There is hope out there. There are amazing doctors and fertility specialists who have access to the latest medical technology to help you conceive. You can have a baby, but just don’t wait too long (see point 6!)

9. Infertility is not the end of the road: If you are struggling to conceive, there are many options open to you. Families are built in all different ways and thank goodness we have things like egg donation, sperm donation, surrogacy, adoption and foster care. If you are open to it, there are many ways to have children.

10. Infertility is hard, but getting it ‘right’ is worth everything and more: Doing 10 IVFs and having so many pregnancy losses was harrowing. My journey was a long, tough one but I would do it all again a million times over in order to be a mother. Being my children’s mother is an honour and a privilege and I am reminded every day how incredibly lucky I am that I eventually succeeded. I hope you get your ‘happily ever after’ too.

Although women over age 50 who become pregnant via egg donation are at an elevated risk for developing obstetrical complications, their complication rates are similar to those of younger recipients, according to a study by Columbia University Medical Centre researchers to be published in the February 2012 issue of the American Journal of Perinatology. This is contrary to epidemiological data suggesting that these women are at greater risk of certain complications of pregnancy, including hypertension, gestational diabetes, premature birth, and placenta abnormalities.

In the largest single-centre study of older women who became pregnant from egg donation, Mark V. Sauer, MD; Daniel H. Kort, MD; and colleagues studied 101 women age 50 and over. They compared their pregnancy results with those of egg-donation recipients age 42 and younger. The two groups were evaluated for significant differences in perinatal complications, gestational age at delivery, baby’s birth weight, and mode of delivery. Although the women all received their fertility treatment at Columbia University Center for Reproductive Care, their prenatal care and delivery often took place elsewhere.

Both older and younger women had similar rates of gestational hypertension, diabetes, cesarean delivery, and premature birth. Two women in the older group experienced a serious adverse effect. A 56-year-old woman developed heavy vaginal bleeding at 29 weeks of pregnancy and had to deliver by emergency cesarean hysterectomy 2 weeks later. She recovered with no further complications. A 49-year-old woman (who would have been age 50 at term) died following acute cardiac arrest in her first trimester. The researchers believe that her death was unrelated to her pregnancy and more likely attributable to her heavy smoking habit, which she had not disclosed to her doctors.

The study concluded that all women who use egg donation to become pregnant are at an elevated risk for obstetrical complications, particularly hypertensive disorders and cesarean section; but women over age 50 do not appear to face any greater risk than their younger counterparts.

“It is imperative that all older women undergo thorough medical screening before attempting pregnancy to ensure the best possible outcome,” said Mark Sauer, professor of obstetrics and gynecology at Columbia University Medical Center (CUMC). “But, really, that should apply to younger women, as well.”

“Although many social and ethical questions surround the use of assisted reproductive technology by this age group, the current study confirms the high success rate and relative safety of such pregnancies in well-cared-for women,” said Daniel H. Kort, a postdoctoral fellow in obstetrics and gynaecology.

When people hear or think about South Africa, they usually conjure up Hemingwayesque images of a sun-drenched land where majestic big game roams through unspoiled and breathtaking scenery.

They’re spot on, of course. But that is just a small part of what the country has to offer. For an increasing amount of people, South Africa is fast becoming more than just a destination where their sun-and-safari dreams will come true. These days, many people are also travelling here from all over the world in an attempt to fulfill an ultimate personal dream and desire: Parenthood.

Over the last few years, South Africa has emerged as one of the foremost fertility treatment destinations in the world, with outstanding clinics and the latest technology allowing for state-of-the-art treatment. In addition, South Africa offers a large database of first class eggs donors from all races and ethnicities. Unlike other foreign egg donor programs, future parents are able to view full information about prospective donors including family history, education history, medical information etc as well as photos of the donor as a child.

That all sounds fair enough, but why should European nationals take on the expense and time to travel halfway across the world for treatment that they could undergo much closer to home?

Why? Because not only is the treatment reasonable priced, but it is also highly successful. South African fertility clinics are rated among the best in the world. But the main motivating factor is access to the large database of donors – there is no waiting list! The wait for a donor is only as long as it takes to choose a donor that meets all your requirements. Within three months of choosing a donor, future parents could be back home, with a baby on the way.
The favourable exchange rate also enables many patients who travel to South Africa from Europe and elsewhere for fertility treatment to combine the trip with a vacation. Such medical tourism, sometimes also called ‘IVF/Egg safaris’, is becoming increasingly popular in South Africa as more patients and their partners decide to go on that dream safari while here for their IVF treatment.

The clear legislation and ethics surrounding egg donation are additional factors that set South Africa apart as a favourite fertility destination, ensuring that not only are the rights of the future parents and their prospective children taken care of, but the well-being and safety of the donor always remains paramount.

Current legislation allows egg donors in South Africa to remain anonymous. Local donors are healthy young female volunteers between the ages of 21 and 34 years of age. Although they do receive reimbursement for their donation, it essentially only covers incidentals they may have incurred while participating in the donor programme, such travelling to and from the clinic. The amount has been carefully regulated to ensure that donors donate for altruistic reasons only.. The egg donors in South Africa are therefore not motivated by money, but are really doing this as an act of extreme kindness to make a genuine difference in someone else’s life.

Excellent medical care, a wide range of available donors, similar cultures, the same language and time zone plus a very favourable exchange rate make South Africa is an ideal destination to pursue donor egg IVF for the European fertility patient. The opportunity to combine all of this with a fantastic vacation? Just what the doctor ordered.

The Daily Mail reported that when Mark Griffiths and his girlfriend Jeanette Parker still hadn’t conceived after a year of trying, they went to their GP.

He referred them to a gynaecologist and, after a series of scans and tests, it was suggested that Jeanette, 38, might have a blocked fallopian tube.
She underwent four minor procedures which cleared the blockage, at least partially.

‘A number of doctors have given us very poor advice and failed to pick up on my problem,’ said Mark Griffiths, pictured with girlfriend Jeanette Parker. Tests on Mark also revealed that while his sperm count was reasonable, the volume of semen was small and the sperm itself ‘acidic’.

However, the gynaecologist dismissed this as nothing serious. ‘He made a joke about making sure you hit the pot and nothing more was said about it,’ recalls Mark, 42, from Portsmouth.

It was only after Jeanette, a personal assistant, had undergone three unsuccessful IVF cycles — costing £15,000 — plus the removal of one of her two fallopian tubes, which had to be removed after an ectopic pregnancy, that doctors suggested that, in fact, the problem might be with Mark’s sperm. He was referred to a specialist male fertility doctor who diagnosed a blocked ejaculatory duct. This was preventing the normal volume of semen being released.
The condition, which causes up to 5 per cent of cases of male infertility, may be triggered by a cyst or scarring due to prostate infections.

Jeanette and Mark now believe if his problem of a blocked ejaculatory duct had been spotted earlier, it could have made a real difference. Babies can also be born with it. Acidic sperm is another sign of a blockage (it also contributes to infertility by making sperm attack the eggs, rather than fertilise them).

Last July — three years after being sent to the gynaecologist — Mark had an operation to clear the blockage.
Research shows up to 30 per cent of those with this condition go on to conceive naturally, suggesting the three IVF attempts Mark and Jeanette endured might not have been necessary. IVF conceptions are twice as likely to end in an ectopic pregnancy (a potentially life-threatening condition where the embryo implants outside the womb).

By costing her a fallopian tube, IVF has actually made it more difficult for Jeanette to conceive — and even if she does, she is at increased risk of another ectopic pregnancy.
‘It has been a very traumatic and costly few years which may all have been unnecessary,’ says Mark, a fire sprinkler installer.

‘A number of doctors have given us very poor advice and failed to pick up on my problem, which is very disappointing.’ In fact, the couple had previously managed to conceive naturally and have a six-year-old son — they now believe if Mark’s problem had been spotted earlier, it could have made a real difference. ‘If I’d had the procedure at the beginning, Jeanette would have most definitely had a greater chance of a natural conception,’ he says.
Mark is just one of thousands of men whose fertility problems are going undiagnosed and untreated, according to some of the country’s leading male health doctors.

Jeanette and Mark had previously managed to conceive naturally and have a six-year-old son
They blame the fact that IVF clinics tend to focus on women’s fertility issues, with little attention paid to men’s problems. Most clinics don’t even employ a male fertility specialist, they say. As a result, some women are going through expensive, and often gruelling, IVF unnecessarily.
As Rowland Rees, a urological surgeon at the Royal Hampshire County Hospital, Winchester, explains: ‘The majority of fertility clinics are gynaecology-led, where the emphasis is on investigating the female partner and carrying out assisted conception.

‘The investigation and treatment of male-related fertility problems is often not done thoroughly enough, and sometimes not at all. In half of cases male problems are partly responsible and, in 20 per cent, it is purely a male issue. Around 50 per cent of male fertility problems are treatable, but unfortunately this is commonly overlooked.
‘Therefore, couples are undergoing IVF — with all the inherent costs and emotional turmoil it can cause as well as the risks to women from conditions such as ovarian hyperstimulation — when they could have conceived naturally had the man been treated. Treating male infertility may also be cheaper, more successful, and less invasive.’

Fertility problems, defined as a failure to conceive after a year of regular, unprotected intercourse, affect around one in six couples. Male infertility can be caused by various factors. One of the most common is low sperm count. A very low sperm count of less than five million sperm per millilitre may be caused by rare genetic conditions such as Klinefelter’s syndrome, Kallmann’s syndrome or Kartagener’s syndrome.

For some men, simply changing their lifestyle is all that is needed to rectify a low sperm count For some men, simply changing their lifestyle — stopping smoking, eating healthily, exercising and cutting down their alcohol and caffeine consumption — is all that is needed to rectify the problem.
Antidepressant drugs, certain types of medication such as chemotherapy, injury to the testes and infections such as chlamydia or mumps, can also affect a man’s fertility.
In 40 per cent of cases, problems are caused by varicose veins in the testes, a condition known as varicoceles.
With many of these conditions, a microscope-assisted procedure, carried out as a day case, can help rectify the problem. For example, a simple procedure to tie off veins containing a faulty valve causing a varicocele may significantly improve pregnancy rates.

But too many men are never offered treatment, says David Ralph, a urological surgeon at University College Hospital London. ‘If a couple goes to an IVF unit, they generally get IVF,’ he says. ‘In many fertility clinics, if a man’s sperm sample comes back as low, the solution is often immediately to have a type of in vitro fertilisation treatment called intracytoplasmic sperm injection (ICSI) — where sperm is surgically removed from the man then injected into an egg to fertilise it.

But there have been major advances in male fertility treatment since IVF and ICSI were introduced some 20 years ago. ‘These now allow successful treatment of many male fertility problems, allowing the couple to conceive naturally. What’s more, corrective procedures are about half the price of ICSI.’

Furthermore, going straight to sperm injection means couples will encounter the same problems conceiving if they want another baby, because the underlying condition has not been treated. And if the problem is a hereditary condition and has not been diagnosed, the man may unknowingly pass it on to his child.

The reason why men are being overlooked is the way fertility care is set up in Britain, say the doctors. Couples with fertility problems tend to be sent by their GP to a gynaecologist for tests or bypass their GP altogether and refer themselves directly to an IVF clinic. But most fertility clinics do not have a urologist who specialises in male infertility — an andrologist — on their team.

Furthermore, if sperm does need to be surgically extracted for IVF, the operation is often carried out by a gynaecologist, says Mr Rees. ‘Andrological problems, such as testicular lumps, low testosterone, erectile dysfunction or ejaculatory problems, may not be picked up on or dealt with,’ he says.
‘Many men are going along their partners to a clinic, are being asked to produce semen and, in some cases are having it surgically extracted without looking at the reasons for a low sperm count or treating it.

‘If men do require surgery to find sperm, this is bizarrely done by gynaecologists — women’s health specialists — as opposed to men’s health specialists. ‘This is not the case in most other countries, where things have been set up differently.’

Yet fertility clinics are not solely to blame. For years male infertility has been neglected as a medical speciality, with urologists focusing on other areas such as cancer and prostate disease, adds Mr Rees. ‘This is now changing and andrology is expanding as a distinct sub-speciality.
‘It’s probably ten years overdue, but if we can treat the cause of male infertility we could prevent many couples having to go through IVF.

‘However, fertility is big business and clinics do not want to give up patients.’ As with all medical problems, the best way to ensure you are seen by a male fertility specialist is to go through your GP, who can refer you to a urologist specialising in fertility, adds Mr Rees.

‘Most regions in the UK now have a male fertility specialist,’ he says. ‘The thing to avoid is self-referral to IVF units before you know what the problem is.’
Meanwhile, although Mark Griffiths’s sperm count and volume are now normal, he and Jeanette have not yet conceived and are planning IVF again because they are ‘getting older’. Mark is urging men who think they may have a fertility problem to seek help from a specialist sooner rather than later. ‘It could prevent a whole lot of heartache and hopefully lead to the baby you are wishing for,’ he says.

The very name of our company, Nurture, embodies caring, caretaking and cherishing. We proudly live up to our name, not only in the myriad of ways that we care about the well-being of our clients, but also in the proactive steps we take to extend that same kindness to the environment.

Although we are a small company, consisting of only six women, we strive to make an enormous difference in the world. That is why we also try to be as eco-conscious as possible.

Being ‘green’ is the new black nowadays, but our eco-conscious efforts are not about trying to be trendy or politically correct. It turns out the issue hits close to all of our hearts. In recent years, various studies conducted by researchers around the world have come to the disturbing conclusion that a range of environmental toxins, including traffic pollution, are responsible for an increase in male infertility.

In an effort to minimise our own carbon footprint, all of us at Nurture work from home. Apart from the obvious perks this entail – such as being able to spend more precious time with our families and not having to deal with maddening traffic jams during a daily commute – it also means that we are polluting less, since minimal driving translates into less harmful carbon fumes being released. Not to mention less personal fuming due to road rage! Those are just as harmful to everyone’s general health and well-being.

By telecommuting, we also save money on fuel (score!) and we save paper (and by extension, trees) too, since we handle most of our correspondence online. All of our donor applications, consent forms, recipient applications and agreements, and proof of payment notifications are conveniently done online. We print documents only when absolutely necessary, such as when a recipient requests a fully signed agreement, in which case the document is printed, signed and scanned, before once again being sent back as an online attachment.

By doing our part, we hope to preserve the planet for all of our and your children – present and future.